Posted in Access to healthcare, Affordable Care Act (ObamaCare), Community Underwriting, Economic Issues, Employee Benefits, Essential Benefits under the ACA, Government Regulations, Health Insurance, Healthcare financing, Individual Market, Individual ObamaCare Market, Individual Underwriting Standards, Insurance subsidies, Large group insurance market, Medicaid, Medicaid Expansion, Medical Costs, Policy Issues, Uncategorized

Analysis of the ACA: A Public Policy “Devil in the Details”

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Individual Health Shrinkage Drives Up Uninsured Rate: CBO Data

~Enrollment in every other major type of coverage grew or held steady~

The subtitle in the article above is correct: Enrollment in every other major type of coverage grew or held steady.

But this should not surprise anyone.

“Why the other major types of coverage increased, is the more important question. And examining this also reveals that the real, or net, uninsured rate probably went up much less than 5%.

The CBO data, based on their own definition of “insurance”, was destined to over-state the number of uninsured based on these data…

“CBO includes only major medical insurance that meets ACA minimum essential coverage standards in that definition. It excludes people who belong to health care cost sharing ministries. It also excludes people who are using products such as short-term health insurance as alternatives to major medical coverage.”

Nor does the number of “uninsured” mean that those folks went without care, especially those who might have cash-friendly Primary Care providers, or a Direct Primary Care physician.

And, as premiums continue to rise in the individual market we will see a shift from Unsubsidized plans to subsidized plan; and just as the data indicates we’ve witnessed a 300,000 shift in that direction.

Let’s examine some recent history as a perspective.

The first two enrollment periods after implementation of ACA in late 2013 and 2014, which also corresponded to economic recovery (no cause and effect) showed that the largest portion of newly insured (following the nadir of the uninsured rate) came from the Employer group market as hiring increased; and the second largest portion came from Medicaid and the smallest percentage from the individual market in form of ACA exchanges.

When you measure the effects directly attributable to ACA, the largest percent gains in insured rate have come from new Medicaid, followed by subsidized ACA plans.  This is a crowd-out phenomenon at work, catalyzed by subsidized coverage (Medicaid expansion) on one end and rising premium prices in the Individual market on the other.

This is horrible public policy as it doesn’t promote insurance to be more affordable or efficient, it simply shifts the burden to the public sector while making premiums more expensive.  And those premium increases are a direct result of regulations placed on the Individual Market: Community Rating, guaranteed issue and compression of the age ratios to 3:1, in an attempt to force it to “behave” more like the group market.

So does it really make sense to purposefully, by design, cause the price of insurance to rise and then turn around and subsidize the same product to make it “affordable”?  I guess we know how they justify the name… Affordable Care Act… but there certainly isn’t any buyer protection from soaring prices!

All of which goes to show, that the net effect of the ACA has been to make the individual market UNAFFORDABLE which effectively shunts the demand into gov’t sponsored and/or subsidized coverage!

This is NOT a sound healthcare policy.  But it is a very effective form of legal plunder accomplished by using the law to benefit a few special interests at the expense of the many.

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Community Underwriting, Crony Capitalism, DC & Related Shenanigans, Economic Issues, Employee Benefits, Free-Market, Government Regulations, Health Insurance, Healthcare financing, Individual Market, Individual ObamaCare Market, Insurance subsidies, Medical Costs, News From Washington, Patient Choice, Policy Issues, State-Run Insurance Exchanges, Uncategorized

Judge strikes down association health plan rule as ACA runaround

New York state and the special interests who want to maintain the ACA-dependent grip on the market are at it again.

Using a similarly contorted legal and regulatory logic that went into the design and subsequent SCOTUS justification for the ACA, a Federal District Court in District of Columbia (Judge John C. Bates) has ruled to block the Labor Department’s final rule on the implementation of Association Health Plans as an “end-run” around the ACA.

So let’s all pretend it all worked out just peachy, as the flimsy arguments made by the Plaintiffs suggest, and remove yet another financial tool which might help small businesses and individuals obtain affordable, more portable coverage!

Ostensibly and officially, the goal of the ACA was to expand affordable health insurance coverage.  Yet it has, arguably and predictably, expanded the Health Insurance Industrial complex by propping it up with tax-payer subsidized funds and making insurance MORE expensive.

And who cautions against the new AHP final Labor Department rules?  Who else but the American Health Insurance Plans (AHIP).

 “…we remain concerned that broadly expanding the use of AHPs may lead to higher premiums for consumers who depend on the individual or small group market for their coverage.  Ultimately, the rule could result in fewer insured Americans and may put consumers at greater risk of fraudulent actors entering this market.”

Really? Higher premiums? Compared to what?

In the ACA individual market insurance exchanges, single coverage premiums (unsubsidized) increased by 62% and family coverage premiums increased by 75% just since implementation of ObamaCare!

The financial life support of the community rating standards in the ACA Individual Market was contingent on a “Young-Healthy” participation rate of roughly 40%. It never happened as predicted, thus the skyrocketing premiums in the Individual Market.

The only concern of opponents of AHPs and other market reforms is to ensure that our healthcare dollars keep flowing through the channels they control.

Source: Judge strikes down association health plan rule as ACA runaround

Posted in Community Underwriting, Education, EPA, Government Regulations, outcomes measurement, Policy Issues, Technology, Uncategorized, Unsettled Science

Watch “Can Climate Models Predict Climate Change?” on YouTube

Listen to physicist Will Harper discuss the complexities and major factors in climate change, and why climate modeling predictions are not reliable.

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Community Underwriting, Economic Issues, Free-Market, government incompetence, Government Regulations, Health Insurance, Healthcare financing, Individual Mandate, Individual Market, Insurance subsidies, Medicaid, Medicaid Expansion, Medical Costs, medical inflation, Medicare, Organizational structure, outcomes, Policy Issues, Uncategorized

Hard Truths about Health Care ‌ by Michael Tanner

Micheal Tanner
Michael Tanner

“Every health-care system in the world rations care in some way, either through bureaucratic fiat (Scandinavia, the U.K.), waiting lists (Canada), or price (that’s us). One can argue about which of these rationing mechanisms is fairest or most efficient, but let’s not pretend that it won’t occur.”

http://www.nationalreview.com/article/446439/health-care-basic-facts-and-hard-truths

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Community Underwriting, Economic Issues, Employer Mandate, Employer-Sponsored Health Plans, Free-Market, Government Regulations, Health Insurance, Health Reimbursement Arrangement (HRA), Health Savings Accounts (HSA's), Individual Mandate, Individual Market, Individual Underwriting Standards, Insurance subsidies, Medicaid, Medical Costs, Medicare, Patient Choice, Policy Issues, Portable Insurance, Pre-existing Conditions, Reforming Medicaid, Subsidies, Tax Policy, Uninsured

Components of Optimal Health Insurance: # 3 – Uninterrupted Ownership | Robert Nelson, MD | LinkedIn

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Robert Nelson, MD

Installment #3 of Components of Optimal Health Insurance will discuss how regulatory and tax policy has contributed to the health care insurance crisis by promoting “job-lock”.  Tax laws and insurance regulatory policy need to change in order to affect real health insurance reform. 

via Components of Optimal Health Insurance: # 3 – Uninterrupted Ownership | Robert Nelson, MD | LinkedIn.

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Bailouts, Community Underwriting, Economic Issues, Health Insurance, Individual ObamaCare Market, Individual Underwriting Standards, Medical Costs, News From Washington, DC & Related Shenanigans, Organizational structure, Policy Issues, Risk Adjustment, Uncategorized, Uninsured

Obamacare’s Co-Ops: A Bigger Scandal Than Solyndra? – by Scott Gottlieb

Untitled-10This butchery didn’t come about without a lot of government assistance along the way. Collectively, the taxpayers have loaned the co-ops more than $2.4 billion spread over just 23 health plans. Now, Uncle Sam stands to lose a good chunk of that money as the plans start filing for bankruptcy. In Iowa, the bankruptcy of just one co-op will likely cost taxpayers all of the $180 million they flushed into the insurer.

The New York Times blamed the failure of that Iowa plan, which went by the name CoOportunity, on the co-op’s success. The newspaper’s healthcare reporter reasoned that the plan proved so popular with consumers, it exhausted its budget.

Another way to look at it is that the co-op robbed its customers. They knowingly underpriced their product, took in more revenue than they could service, and then hid behind bankruptcy proceedings when they couldn’t meet the obvious demand. In business vernacular, this is a variation of the age-old Ponzi scheme. In the New York Times, it’s sadly portrayed as an inspiration – the co-op a victim of its own munificence.

Progressive architects hailed co-ops when the plans unveiled amazingly low rates last year. It seems that was the last political gasp of a dying dogma. Measuring the risk of a population of beneficiaries, and pricing an insurance product, turns out to be a hard business after all. The profit motive is a reasonable way to ensure that beneficiaries actually get the services they’re promised.

via Obamacare’s Co-Ops: A Bigger Scandal Than Solyndra?.

Posted in Affordable Care Act (ObamaCare), Community Underwriting, Deductibles, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Health Insurance, Health Savings Accounts (HSA's), Individual Mandate, Individual Market, Individual Underwriting Standards, Large group insurance market, Medicaid, Medicaid Expansion, Medical Costs, Pre-existing Conditions, Risk Adjustment, Tax Policy, Uncategorized

Can ObamaCare Be Fixed? Part II | John Goodman’s Health Policy Blog | NCPA.org

Can ObamaCare Be Fixed? Part II

Read Part 1 Here:

The reason we have so many problems in health care is that almost everywhere we look, people face perverse incentives — patients, doctors, employers, employees, etc. When they respond to those incentives they do things that make costs higher, quality lower, and access to care more difficult than otherwise would have been the case.

At the root of those perverse incentives is bad public policy.

Pre-ObamaCare Distortions That Affected Important Choices

Insurance or Uninsurance? Because we were spending far more on free care for the uninsured than we were spending on subsidies for individually-purchased insurance, millions of people had an incentive to be uninsured.

Public or Private? Because we spent far more on such public programs as Medicaid and CHIP than we spent on subsidies for individually-purchased insurance, millions of people had an incentive to choose public insurance rather than private insurance.

Individual or Group? Because employer-provided insurance was generously subsidized through the tax law while individually-purchased insurance received almost no tax relief, the vast majority of people with private insurance had non-portable, employer-provided coverage.

Third-Party or Self Insurance? Because employer-provided insurance was liberally subsidized through the tax law while people’s ability to get similar subsidies for Health Savings Accounts (HSAs) was greatly restricted, people had too much of the former and too little of the latter. This in turn led to third-party payer domination of the entire medical marketplace and the elimination of real market-determined prices.

Choices in the Market for Risk Avoidance. Because normal market forces had been so completely repressed, outside the individual market real health insurance simply didn’t exist.

via Can ObamaCare Be Fixed? Part II | John Goodman’s Health Policy Blog | NCPA.org.

Posted in Community Underwriting, Cost of labor, Economic Issues, Employer Mandate, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Federal Exchanges, Government Regulations, Health Insurance, Individual Mandate, Individual Market, Medicaid, Medical Costs, Policy Issues, Pre-existing Conditions, Price Tansparency, State-Run Insurance Exchanges, Tax Policy, Uncategorized, Unemployment

Replace Obamacare, Stat | National Review Online

The proposal I suggest would achieve four remarkable things: It would be more progressive than Obamacare, because it would involve more distribution from higher- to lower-income households. It would provide genuine protection for people who have a preexisting condition, as opposed to the bait-and-switch promises of Obamacare. It would provide genuine access to care for everyone, as opposed to leaving 30 million uninsured, as Obamacare does. And it would work in practice, primarily because it would confine the role of government to setting a few simple rules of the game, leaving individual choice and the marketplace to do the heavy lifting.

I call this reform a “consensus reform” because it draws not just on such right-of-center think tanks as the Heritage Foundation, the Cato Institute, and the American Enterprise Institute but also on such left-of-center think tanks as the Brookings Institution and the Urban Institute, and various scholars including President Obama’s former and current economic advisers, Peter Orszag and Jason Furman. It takes the best ideas these folks have offered and combines them with an important principle: No plan designed by those at the top can ever work unless people at the bottom have an economic incentive to make it work.

via Replace Obamacare, Stat | National Review Online.